Coronavirus disease (COVID-19) is overwhelming hospitals with patients requiring respiratory support, including ventilators and Extracorporeal Membrane Oxygenation (ECMO). Bottlenecks in device availability may contribute to mortality, and limited device availability even in ECMO centers has led to rationing recommendations. https://www.selleckchem.com/products/vorapaxar.html Therefore, we explored options for ad hoc construction of venovenous ECMO using readily available components, essentially, large cannulas, membrane oxygenators, and blood pumps. As thousands of certified cardiac Impella pumps are distributed worldwide, we assembled lean ECMO by embedding Impella pumps coaxially in tubes, combined with standard gas exchangers. Ad hoc integration of Impella blood pumps with gas exchange modules, large-bore venous cannulas, regular ECMO tubing, Y-pieces, and connectors led to lean ECMO systems with stable performance over several days. Oxygenation of 2.5-5?L of blood per minute is realistic. Benefit/risk analysis appears favorable if a patient needs respiratory support but required support systems in a center are exhausted. Ad hoc assembly of venovenous ECMO is feasible using Impella blood pumps, results in stable blood flow across gas exchange modules, and thus may offer another opportunity to oxygenate, "recover the lungs" and hopefully save lives in selected patients with severe COVID-19 disease even when conventional life support equipment is exhausted. The lean design also yields inspirations for future ECMO systems.Mitral regurgitation (MR) is an important consequence of heart failure (HF) patients, which increases hospitalization and mortality rates. The MitraClip procedure is increasingly preferred for HF patients with obvious MR to improve MR and related symptoms. In some cases, patients may need further intervention such as left ventricular assist device implantation with the aim of improving progressive clinical deterioration caused by the progression of HF or mitral clip associated complications (i.e., detachment or mitral stenosis). This case study summarizes our two patients who received concomitant mitral clip removal and left ventricular assist device implantation with clinically successful results.A 52-year-old man had shortness of breath and chest discomfort for 2 months. Chest CT and MRI showed a mass in the left atrium attached to the mitral annulus without obvious enhancement. Initial diagnosis was suspected of myxoma. Preoperative FDG PET/CT demonstrated the corresponding lesion with abnormal FDG uptake, indicating a malignancy. Finally, histopathologic examination revealed primary undifferentiated sarcoma.Brain death is the complete, irreversible cessation of brain function, including the capacity for brainstem, respiratory, and vegetative activities. It is a clinical diagnosis that can be supplemented with brain perfusion imaging. Absent cerebral blood flow can be visualized with CT angiography or perfusion scintigraphy. F-FDG PET/CT, visualizing glucose uptake, is another approach that has been shown to indicate brain death in small case series. We here present a case with unsuspected absent F-FDG uptake and thus no metabolic activity, in the brain. The patient was declared brain dead later the same day.Myeloid sarcoma (MS) is a rare entity, and FDG PET/CT is a useful tool for staging at diagnosis and response assessment. We present a case of a 72-year-old woman diagnosed with multifocal extramedullary MS, using FDG PET/CT to guide palliative radiotherapy to 13 sites of disease over 2 separate relapses with complete and durable local responses and minimal toxicity. This case represents the largest reported burden of disease in MS successfully treated with FDG PET/CT-guided radiotherapy.Sarcoidosis is a systemic disorder of unknown etiology characterized by development of noncaseating granulomas in more than 1 organ system. Development of sarcoidosis during or immediately after chemotherapy and immunotherapy is not uncommon. We present a 61-year-old woman in whom restaging F-FDG PET/CT detected asymptomatic sarcoidosis after neoadjuvant chemoradiotherapy for carcinoma rectum, which resolved spontaneously by the end of adjuvant chemotherapy with no specific treatment. Recognition of anatomic-metabolic pattern of sarcoidosis could prevent erroneous upstaging of the primary malignancy during restaging PET/CT following chemotherapy, and such lesions may show self-resolution.The aim is to explore the concept of photopenic defects in newly diagnosed glioma patients with the 2 widely used C-MET and F-FDOPA PET amino acid tracers. Thirty-two C-MET and 26 F-FDOPA PET scans with amino acid PET-negative gliomas were selected in this European multicentric study. Of these gliomas, 16 C-MET and 10 F-FDOPA PET scans with photopenic defects were identified, exhibiting lower mean tumor-to-background ratio as compared with isometabolic gliomas (P less then 0.001). Gliomas with photopenic defects had no different progression-free survival than isometabolic gliomas in the whole population (P = 0.40), but shorter progression-free survival in the subgroup of World Health Organization grade II IDH-mutant astrocytomas (35 vs 68 months; P = 0.047).Myoepithelial carcinoma is an exceedingly rare malignant neoplasm that most frequently occurs in the salivary gland. We here report a case of myoepithelial carcinoma in a 57-year-old man. Unenhanced and contrast-enhanced CT scans showed an ill-defined, heterogeneous, contrast-enhancing mass in the left parapharyngeal space, which suggested malignancy. F-FDG PET/CT showed a hypermetabolic mass and multiple FDG-avid lymph nodes in the bilateral cervical regions. An incision biopsy was performed, and the pathological examination confirmed the mass to be a myoepithelial carcinoma.PSMA-based nuclear medicine imaging impacts increasingly the clinical decision process in prostate cancer patients. A well-known PSMA pitfall is uptake into autonomic ganglia. The intensity of uptake, the shape, and the exact location of the correlating structure in CT are supposed to aid discriminating between ganglia and lymph node metastases. In this patient, we found intense uptake in a nodular shaped para-aortal soft tissue lesion suspicious of a lymph node metastases at staging as well as restaging. After secondary resection, the lesion was histologically proven an autonomic ganglion with intense PSMA expression.